Health

There’s an old adage that black doesn’t crack. And while darker skin may appear more resilient to the signs of aging, it’s not immune to melanoma – the most severe form of skin cancer.

Anyone can get skin cancer, but many African Americans underestimate their risks and fail to protect themselves from the dangers of the sun’s ultraviolet rays – a leading cause of skin cancer.

Many people, even some doctors, have long assumed that pigment melanin in darker skin can protect against skin cancer. While it does offer protection against sunburn, exposure to UV rays can damage skin and lead to the formation of cancer regardless of skin tone.

“The key is you want to really reduce the amount of ultraviolet exposure you have,” said Dr. Richard L. White, chief of the Division of Surgical Oncology and co-director of the melanoma and breast programs at Levine Cancer Institute. “Melanoma is the fifth most common cancer in men and the sixth most common cancer in women. And yes, it is five to ten times more common in Caucasian folks, but that doesn’t mean that black people don’t get it.

While melanoma is less common among African Americans, it is usually diagnosed in African Americans and other minorities at a later stage, when the disease is advanced and harder to treat.

“It just disheartens me,” said White. “People show up, and they basically say, ‘Well, I’m black. I didn’t think I could get this so I didn’t do anything about it until it was bleeding.’ And that’s not the time to find it.”

White said it is important to identify the signs and symptoms of skin cancer and seek treatment early. When skin cancer is found early, it can be treated more easily.

A change on the skin is the most common sign of skin cancer. This may be any new mole or growth on the skin, a sore that doesn’t heal, or a change in an old growth.

White said the majority of the African-American patients he sees with melanoma ignore these early signs.

“The sad reality is the majority of people we see who are of African-American decent, often present with really bad problems,” he said. “Often they are sort of blowing it off as, ‘I had this smudge on my foot… now it is bleeding.’ Those are people that probably have a 60 percent chance of death from melanoma.”

White recommends regularly checking the surfaces of your body for any new, changing or expanding spots. He said African Americans should definitely pay close attention to any spots on the lighter areas of skin, such as the palms of their hands and soles of their feet.

Most doctors follow the A-B-C-Ds of detection. A is for asymmetry. Does one side of the spot look different from the other? If so, that is abnormal. B is for border. Is the spot a round dot or does it look like Greenland or Australia? If it’s not round, it could be a problem. C is for color. If the spot has multiple colors, it should be evaluated by a medical professional. The D is for diameter. Any spot bigger than the end of a pencil eraser is one that needs attention.

“Many doctors are now adding an ‘E,’” said White. “The E is for evolution. Is it new? Is it changing?” If the answer is yes, seek treatment.

While the sun is not the only cause of skin cancer, avoiding exposure to UV rays is one of the best ways to prevent it. Protection goes beyond sunscreen. It also means staying out of the sun between 10 a.m. and 4 p.m., the peak times of day when the sun’s rays are strongest. And when you are in the sun, wear protective clothes that cover your arms and legs, a hat that shades your face and ears, and sunglasses that filter out UV light to protect your eyes.

“Hats with a brim can be really even more helpful than sunscreen,” said White. “I tell people to think of sunscreen as the last line of defense. There are three. You should use your brain first, then use protective clothing second, and sunscreen is the last.”But let’s be honest: most of us will not spend the summer months covering our arms and legs so we should apply sunscreen to those exposed areas of skin before going out in the sun, even briefly.

When selecting a sunscreen, find one that has a sun protection factor, or SPF, of 15 or higher and that is labeled “broad spectrum,” meaning it can filter both UVA and UVB rays.